Attention-deficit/hyperactivity disorder and short sleep duration among U.S. school-aged children

Attention-deficit/hyperactivity disorder (ADHD) has been linked to sleep disturbances. There is little evidence of this association among a nationally representative sample of school-aged children. This study explored the association between current ADHD diagnosis and short sleep duration among U.S. school-aged children. Parent-reported severity of ADHD and short sleep duration among those with a current ADHD diagnosis was also assessed.

A secondary analysis of 2020-2021 National Survey of Children's Health (NSCH) data including 26,148 U.S. children ages 6-11 years was performed. Sleep duration was categorized using the National Sleep Foundation's age-specific recommendations defining <9 hours as short sleep duration. Weighted unadjusted and adjusted logistic regression models were performed. The adjusted models included child age, sex, race/ethnicity, health status, overweight status, screen time, physical activity, parent education, family structure, and federal poverty level.

Nearly 10% of children currently had an ADHD diagnosis, with 62% having moderate or severe ADHD. Over one-third (35%) had reports of short sleep duration. Unadjusted (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.35-1.84) and adjusted (adjusted OR [AOR] = 1.25, 95%CI = 1.06-1.47) results indicated that children with ADHD were at increased odds of having short sleep duration compared to children without ADHD. Among children with ADHD only, unadjusted (OR = 1.70, 95%CI = 1.26-2.31) and adjusted (AOR = 1.61, 95%CI = 1.19-2.19) results indicated that children with a moderate or severe diagnosis were at increased odds of having short sleep duration than children with a mild diagnosis.

ADHD may influence short sleep duration among U.S. school-aged children. Behavioral sleep treatments should aim toward improving sleep duration among this population.